Multi- and Unifocal Thyroid Microcarcinoma: Are There Any Differences?

Kaliszewski, Krzysztof; Zubkiewicz‐Kucharska, Agnieszka; Wojtczak, Beata; Strutyńska−Karpińska, Marta

doi:10.17219/acem/62327

Cited by 7 publications

(4 citation statements)

References 23 publications

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“…A retrospective analysis involving 2,095 PTC patients reported that multifocal tumors (32% of cases) had a significantly higher ETE incidence than unifocal tumors (20). However, other studies report that the tumor characteristics of UMPTC and UUPTC are similar (36,37).…”

Section: Discussionmentioning

confidence: 98%

The Differences Between Multifocal and Unifocal Papillary Thyroid Carcinoma in Unilateral Lobe: A Meta-Analysis

Zhang

Wang

et al. 2021

Front. Oncol.

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BackgroundAs many inconsistent reports on the clinical manifestations and prognosis between unilateral unifocal PTC (UUPTC) and unilateral multifocal PTC (UMPTC), identifying the difference should guide management. The purpose of this study was to investigate other additional differences between UUPTC and UMPTC in addition to their difference in the number of cancer foci.Data SourcesA systematic literature search was conducted in the PubMed and Web of Science databases for relevant studies published before December 31, 2020. Their reference lists were also reviewed.Review MethodsTwo reviewers independently extracted data and assessed the quality of eligible studies. Studies on patients who underwent an open thyroidectomy with or without neck dissection were included. Data were analyzed using the RevMan 5.3 software.ResultsFifteen studies comprising 9,665 patients were selected for the meta-analysis. UMPTC occurred in 10% to 36% of all PTC cases. There were no significant differences between UMPTC and UUPTC patients in age, gender, tumor size, and extrathyroidal extension (ETE). However, significant differences (P < 0.05) between UMPTC and UUPTC patients were observed in central lymph node metastasis (CLNM), lateral lymph node metastasis (LLNM), tumor-node-metastasis (TNM) stage I+II, TNM stage III+IV, the recurrence/persistence of the UMPTC group after total thyroidectomy and overall recurrence/persistence.ConclusionUMPTC patients are more likely to have CLNM, LLNM, more advanced TNM stage, and recurrence/persistence than UUPTC patients. Compared with UUPTC, UMPTC patients should undergo central lymph node dissection, and pay more attention to LLNM, TNM stage and recurrence/persistence during the follow-up.

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Section: Discussionmentioning

confidence: 98%

The Differences Between Multifocal and Unifocal Papillary Thyroid Carcinoma in Unilateral Lobe: A Meta-Analysis

Zhang

Wang

et al. 2021

Front. Oncol.

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“…The evolution of TMC is usually indolent and their radical therapy did not contribute to a decrease of mortality, therefore certain authors even recommend conservative therapy and follow-up in these cases [32, 55, 75]. The presence of TMC was also described in up to one third of thyroid gland autopsies of persons deceased for other reasons [58, 71, 73, 74]. Retrospective studies performed in Romania showed a higher incidence of thyroid cancer after the Chernobyl accident [65, 66].…”

Section: Discussionmentioning

confidence: 99%

Coexistent papillary thyroid carcinoma diagnosed in surgically treated patients for primary versus secondary hyperparathyroidism: same incidence, different characteristics

et al. 2019

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Background The coexistence of hyperparathyroidism and thyroid cancer presents important diagnostic and management challenges. With minimally invasive parathyroid surgery trending, preoperative thyroid imaging becomes more important as concomitant thyroid and parathyroid lesions are reported. The aim of the study was to evaluate the rate of thyroid cancer in patients operated for either primary (PHPT) or secondary hyperparathyroidism (SHPT). Methods Our retrospective study included PHPT and SHPT patients submitted to parathyroidectomy and, when indicated, concomitant thyroid surgery between 2010 and 2017. Results Parathyroidectomy was performed in 217 patients: 140 (64.5%) for PHPT and 77 (35.5%) for SHPT. Concomitant thyroid surgery was performed in 75 patients with PHPT (53.6%), and 19 papillary thyroid carcinomas (PTC) were found, accounting for 13.6% from all cases with PHPT and 25.3% from PHPT cases with concomitant thyroid surgery. Thirty-one of operated SHPT patients (40.3%) also underwent thyroid surgery and 9 PTC cases were diagnosed (11.7% of all SHPT patients and 29% of patients with concomitant thyroid surgery). We found differences between PHPT and SHPT patients ( p < 0.001) with respect to age (54.6 ± 13y versus 48.8 ± 12y), female-to-male ratio (8:1 versus ~ 1:1), surgical technique (single gland parathyroidectomy in 82.8% PHPT cases; versus subtotal parathyroidectomy in 85.7% SHPT cases) and presurgical PTH (357.51 ± 38.11 pg/ml versus 1020 ± 161.38 pg/ml). Morphopathological particularities, TNM classification and multifocality incidence of PTC were similar in the two groups. All PTC from patients with SHPT were thyroid microcarcinomas (TMC, i.e. tumors with a diameter smaller than 1 cm), whereas seven out of the 19 cases with PTC and PHPT were larger than 1 cm. Conclusions PTC was frequently and similarly associated with both PHPT and SHPT irrespective of presurgical PTH levels. Thyroid tumors above 1 cm were found only in patients with PHPT. Investigators should focus also on associated thyroid nodular pathology in patients with PHPT.

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“…Multifocal PTC is the most frequently diagnosed multifocal, well-differentiated thyroid cancer, although follicular and medullary thyroid cancer may also present with PTC in the same patient [13]. Patients may be categorized as having multifocal PTMC, multifocal larger PTC, and mixed multifocal PTMC with larger tumors.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic Outcomes of Patients with Multifocal Papillary Thyroid Microcarcinomas and Larger Tumors

Kuo

Chen

et al. 2017

International Journal of Endocrinology

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A retrospective review of 626 patients with multifocal papillary thyroid carcinoma (PTC) including 147 patients (23.5%) with multifocal papillary thyroid microcarcinoma (PTMC) from a total of 2,536 patients with PTC who visited the Chang Gung Medical Center in Linkou, Taiwan, was performed. A comparison of the clinical features between 626 multifocal and 1,910 solitary PTC cases showed that patients in the multifocal PTC group were older and had a smaller mean tumor size, a more advanced tumor-node-metastasis (TNM) stage, and a higher percentage of nonremission status compared to patients in the solitary PTC group. Of the 626 patients with multifocal PTC, the group with larger tumors showed a more advanced TNM stage, a higher percentage of lymph node metastasis and soft tissue invasion, and a higher nonremission rate compared to the multifocal PTMC group. Of the 626 patients with multifocal PTC, 25 patients (4%) died during a mean follow-up period of 7.1 ± 5.3 years. Kaplan-Meier survival curves showed a significantly lower survival rate associated with multifocal PTMC compared to that with solitary PTMC.

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Multi- and Unifocal Thyroid Microcarcinoma: Are There Any Differences?

Cited by 7 publications

References 23 publications

The Differences Between Multifocal and Unifocal Papillary Thyroid Carcinoma in Unilateral Lobe: A Meta-Analysis

The Differences Between Multifocal and Unifocal Papillary Thyroid Carcinoma in Unilateral Lobe: A Meta-Analysis

Coexistent papillary thyroid carcinoma diagnosed in surgically treated patients for primary versus secondary hyperparathyroidism: same incidence, different characteristics

Therapeutic Outcomes of Patients with Multifocal Papillary Thyroid Microcarcinomas and Larger Tumors

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